Last updated: 7/10/24 5:11 PM EDT
A cyberattack against Change Healthcare caused all clearinghouse services to be shut down on 2/21/24. TherapyNotes has migrated claims and ERA features to CLAIM.MD, and we now fully support sending claims and receiving ERAs.
Can I send Claims now?
Yes, TherapyNotes can now send electronic claims to any payer in our payer list whether or not they require enrollment, assuming your enrollment has been completed.
Can I send claims to payers that require enrollment? Why are my claims stuck as “Pending”? And what is enrollment anyway?
Some payers require you to complete paperwork in order to send claims from a new clearinghouse. This is separate from ERA enrollment, which is always required. Do not confuse enrollment with credentialing. Credentialing with a payer means going in network with them.
The enrollment process for sending claims is quick and easy for most payers. There is a new streamlined process built into TherapyNotes to take these steps. This is significantly easier than what was required with Change Healthcare.
The TherapyNotes payer list has been updated to the CLAIM.MD payers and payer IDs instead of Change Healthcare's payer list. For new payer enrollments, submitted claims may initially sit in ‘Pending’ status for 72 hours to give your new enrollment request enough time to complete.
For questions on the new enrollment process, contact our enrollment support team at (215) 658-4550, option 4. Please do not contact CLAIM.MD directly for enrollment support. They are not able to assist and will direct you back to our TherapyNotes Support team.
How do I enroll if my practice has multiple clinicians with their own tax ID and group NPI?
The self-enrollment feature in TherapyNotes uses the practice's tax ID and group NPI from the practice settings. If you have a practice account shared by multiple clinicians (known as co-op practices) with their own tax ID and group NPI (such as in the clinician settings billing overrides), you will need to contact our enrollment team at (215) 658-4550, option 4, to help you complete your enrollment.
PO Box Rejections
We are seeing many rejections due to the presence of a PO box in the address. If you see this rejection reason you need to remove your PO Box from Practice Information, Multiple Practice Locations, and Clinician Billing Setting Overrides. Instead you can put a PO Box in Alternate Billing Address in Practice Billing Settings.
Payer Specific Updates
Capital Blue Cross (Payer ID 23045) now requires enrollment, even if you were previously submitting claims successfully. This change is already in effect within TherapyNotes, so practices will be prevented from submitting any further claims to this payer until they have completed enrollment. For more help completing these steps, read Enroll to Submit Claims.
Pittsburgh Care Partnership Inc (Payer ID 23283) now requires re-enrollment (ERA REENROLLMENT). To do so, the practice will need to access their completed ERA enrollment from the payer page, open the new window, and click the “re-enroll” button. For more help on completing these steps, read Enroll to Receive Electronic Remittance Advice.
Payers that Require Change Healthcare
A number of payers that are dependent on Change Healthcare have not yet been restored by CHC and are therefore unable to receive claims. CLAIM.MD will now reject electronic claims to these payers until the payer is restored by CHC and is able to receive electronic claims. Until then, only paper claims are available for these payers. As connections are restored, we will update the list.
The clearinghouse will still print and mail these claims for you - simply update the payer to remove the Payer ID and provide a mailing address. When you submit the claim from the Submit Electronic Claims page, a paper CMS-1500 form will be mailed to the payer for you. See our recent What's New for more information. Alternatively, you can print and mail the CMS-1500 form yourself. Visit our help article for more information.
Payer Name | Payer ID |
ADVANTICA BENEFITS | 59374 |
Alacura Medical Transportation Management LLC | RP065 |
Alicare | 13550 |
Allegeant | 52193 |
Amalgamated Life PA Alicare | 13343 |
American Health Advantage of Florida | 58379 |
American Healthcare Alliance | 01066 |
American National Ins Co ANICO | 74048 |
American Postal Workers Union He | 44444 |
AmFirst Insurance Company | 64090 |
Associates for Health Care, Inc. (AHC) | 36326 |
Bass Administrators, Inc. | 38238 |
Benefit Plan Administrators Co. Eau Claire, WI | 39081 |
Benefit Risk Management Services | 99320 |
CarePartners of Connecticut | 16307 |
Careworks | 10010 |
Cook Childrens Health Group |
TH104 |
Global Excel Management |
GEM01 |
Harvard Pilgrim Stride Health Plan MA |
04245 |
Healthsource ME |
01041 |
HealthSource N TX Cigna |
75255 |
Healthsource SC |
06119 |
Heritage Consultants |
59230 |
High Desert Medical Group |
95393 |
JP Farley Corporation |
34136 |
Keenan Associates CA |
95279 |
Loma Linda University Adventist |
37267 |
MBA Benefit Administrators Inc |
83028 |
Midwest Health Partners |
76079 |
Novasys Health Network |
71080 |
Oak West Physician Association |
36400 |
OptiMed Health |
96277 |
Patient Physician Cooperatives |
20510 |
PHP TPA Services |
30031 |
Primary Health Network |
82048 |
Rocky Mountain HMO |
SX141 |
S S Healthcare Strategies |
31441 |
SANFORD HEALTH PLANS Repriced Claims |
TP984 |
SelfFunded Plans Inc |
34131 |
St Therese Physician Association |
37116 |
St. Vincent Catholic Medical Center - USFHP |
13407 |
TRUSTED HEALTH PLAN |
L0230 |
UCare of Minnesota |
SX178 |
Udelhoven Health Plan |
92006 |
Unified Life Insurance Company |
RP064 |
VOLUSIA HEALTH NETWORK |
59266 |
Western Mutual Insurance |
37247 |
Why aren't I getting ERAs? What happens to old ERAs I didn’t get?
TherapyNotes is receiving ERAs from CLAIM.MD and Change Healthcare. Enrollment is required, even if you were previously enrolled with Change Healthcare. In many cases, this is as simple as clicking a button. Sometimes, there is paperwork to complete, which is streamlined within TherapyNotes (No printing or faxing required). In some cases, you will be given instructions to follow on the payer’s website.
Change Healthcare is now sending us a backlog of old ERAs as well.
Some payers may be agreeable to resend ERAs to you. Practices are encouraged to call payers to make this request, but not until after you are enrolled to receive ERAs from CLAIM.MD.
Can I do eligibility checks or mail paper claims?
We’ve restored the ability to submit paper claims for the clearinghouse to print and mail on your behalf. To learn more about this feature, read our latest What’s New.
We are continuing our efforts to restore eligibility check functionality.
* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.